Análisis en la externalización de procesos quirúrgicosestudio retrospectivo comparativo entre centro asistencial externo y centro hospitalario de referencia por medios propios

Zusammenfassung

Objectives: The aim of the of the present study was to perform a retrospective comparative cost analysis between the outsourced centers and the referral hospital (Hospital General Universitario Reina Sofía, Murcia, Spain) of the two most frequently outsourced major ambulatory surgery interventions, namely carpal tunnel release and knee arthroscopy. Methods: The sample consisted of 1171 patients on the surgical waiting list who underwent surgery in 2016, 2017 and 2018 in the outsourced private centers and in the referral hospital of the two processes under study. The costs, quality criteria of major ambulatory surgery and demographic characteristics of the sample were compared. Results: A cost difference in favor of the outsourced centers was observed, which represents an efficient measure in the management of health care resources. In addition, there was a decrease in the mean delay, which was closer to the guaranteed times established by the Servicio Murciano de Salud (Murcia Health Service) in patients who underwent surgery in the centers where the procedures were performed. Major ambulatory surgery quality criteria were not affected, regardless of the center where the patients underwent surgery. Conclusions: The outsourcing of surgical processes of ambulatory carpal tunnel release surgery and knee arthroscopy with own means is efficient and of quality, which contributes to reduce costs as well as the average surgery delays and improves compliance with warranty times. It is a management tool that improves the quality of care without compromising patient safety or clinical outcomes.